Mental health featured twice on the 2 November 2015 news headlines. I follow this as a focus for the youth and social policy module I co-lead at Nottingham Trent University and my personal interest and commitment.

The timing was linked to the Comprehensive Spending Review on 25 November. ‘It will set out how the government will both invest in priority public services and deliver the £20 billion further savings required to eliminate Britain’s deficit by 2019/2020.’ HM Treasury, July 2015. That is the nub of it, to both invest in priority public services and to reduce the deficit. 

News item 1 was the letter to government calling for equality between physical and mental health treatment and urging it to accept the need to commit to additional investment in mental health services (my emphasis). This campaign was launched by a cross party trio of former health minister Norman Lamb, Time to Change ambassador and former Labour communications director Alistair Campbell and former Conservative cabinet minister, Andrew Mitchell. It was also signed by more than 200 high profile figures. Their list of 10 major concerns included ‘the lack of access to treatment and long waiting times’. This is not new. 

In his foreword to the Achieving Better Access to Mental Health Services by 2020 (2014:4) the Rt. Hon. Norman Lamb MP, Minister of State for Care and Support advocated  ‘People deserve treatment as soon as their problems emerge, rather than waiting until they are in crisis. They deserve the same standards of access to treatment as people with physical illness. They deserve the same focus on recovery. We have a duty to secure equal rights for people with mental health problems. Nothing less is acceptable.’ The report announced two national waiting time standards for the first time from 1 April 2015 and set out its vision for further progress by 2020. Whilst targeting funding of £40 million in 2014-15 and £80 million in 2015-16 to help people in crisis, further funding was not suggested but rather ‘To make parity of esteem a reality by 2020, we need urgent reforms to the incentives in the system that drive investment and spending.’ This is about targets forcing reallocation of funds from other areas of health. He recognised that this policy follows others with the same intent and ‘today there is still far to travel.’ 

The second item of news featured Lord Harris’s motion to be debated in the House of Lords on 5 November ‘that this House takes note of the case for taking action to address the problems of young people before they enter the criminal justice system in order to reduce the prison population, improve conditions within prison, and focus on the rehabilitation of prisoners, as set out in The Harris Review: Changing Prisons, Saving Lives.’ His review was published in July 2015. ‘Lord Harris told the BBC that there was "still no sign of a government response" to his recommendations’ (The Telegraph: 29.10.15) His focus is  ‘As of 31 December 2014, 101 people under 24 have died in our prisons since April 2007’ through suicide.  The report describes how their vulnerabilities were exacerbated by mental health issues and for some were overlaid by negative stereotypes associated with being from BAME backgrounds. He found that these deaths could have been prevented and he argues ‘In all cases, the State had a duty to care for them’. Again, ‘Lessons have not been learned and not enough has been done to bring about substantive change’ in response to recommendations over the last 15 years.’ (2015:8) The need for more staff leads to ‘In particular, it is clear that NOMS cannot deliver these recommendations without a significant investment of resources’ and ‘Delaying action until the resource position is easier is not an option’ due to the loss of lives and the waste of ‘countless millions’ of pounds (2015:13)

These two calls for action to implement agreed and evidenced policy to ensure mental health has equality with physical health and to prevent further loss of young lives through suicide in prison will need public funds in the short term while reducing long term demands for services and costs to society. Will they fall within ‘priority public services’ to be funded in the CSR? We await the CSR to find out. 

Previous policy:

• Department of Health. (February 2011) No health without mental health: a cross-government mental health outcomes strategy for people of all ages – a call to action. Gov.uk.

• Department of Health. (January 2014) Closing the gap: priorities for essential change in mental health Also called the Mental Health Action Plan. Gov.uk.

• Department of Health. (15 January 2015) Equality for all: Mental Health Act 1983: Code of Practice 2015 Gov.UK.

 

This question is key for me, while I am working with senior teams or participants at a training event. Observation and analysis are needed to ensure any intervention is appropriate and effective. The question may be applied to group dynamics, individual reactions or organisational structure and culture.

It was brought to mind by a recent experience with Royal Mail. The Royal Mail was controversially floated on the London Stock Exchange in October 2013. The Coalition Government policies led to an increase in the procurement by private and public companies of public sector contracts let by central government and local authorities. One argument was that they are more efficient and effective and so cheaper for the taxpayer.  My experience with Royal Mail as a customer recently, compared with that pre 2013, did not bear out this government assumption. I was unable to work out what was going on in Customer Services. 

The story goes – on my return from a weekend away, I found a card from Royal Mail asking me to collect a large parcel from my ‘local’ parcel centre, five miles away. My previous collection point was Swan House, three miles away. I followed the instructions and drove through traffic to the Post Office as directed. The postmistress told me how frustrated she is with customers being given the wrong card for their parcel pick up, which now happens ‘all the time’. Without looking for my parcel, she advised me to go to Swan House. 

I found a large new name on Swan House and no public entrance. The sign ‘Swan House’ was still in a flower bed, looking tatty. So where could my parcel be? In a parallel universe? I rang the customer services number on the card. The advisor assured me the collection point was Swan House. When I told her it had been taken over by another company, she could find no further information about a move of building or a map with the precise location and no colleague was available to help. 

I took the initiative to try the sorting depot further up the road. A sign for Customer Services and visitor parking spaces were promising, although no sign for Swan House. I found a collection desk and asked the member of staff why there were no clues as to the location of Swan House, other than a misleading sign on a closed Royal Mail office. I discovered: 

  • Royal Mail are not allowed to put a sign on the sorting office building
  • They would not put ‘Swan House’ on the Customer Service sign because there are many teams in the building and Swan House is only the south west Leicester team.  
  • Swan House continues to be used on the collection information cards and the Call Centre as the team like the name and do not want to lose it. 
  • The sign cannot be removed from the previous building as the new owners like the name and want to reinstate it on that building. 

Models can provide useful tools in organisation development. I have found David Snowden's award winning Cynefin Framework for decision making relevant and thought provoking for chief executives and chairs of boards seeking a fresh angle from which to analyse their organisation. How to organise a Children's Party provides a humorous introduction to the model. 

Is anyone in Royal Mail asking the question ‘What is going on here?’ Might external consultation be needed to ensure efficient, effective clear communication with customers?